ABSTRACT

Context The increasing use of Internet-based learning in health professions education may be informed by a timely, comprehensive synthesis of evidence of effectiveness.

Objectives To summarize the effect of Internet-based instruction for health professions learners compared with no intervention and with non-Internet interventions.

Data Sources Systematic search of MEDLINE, Scopus, CINAHL, EMBASE, ERIC, TimeLit, Web of Science, Dissertation Abstracts, and the University of Toronto Research and Development Resource Base from 1990 through 2007.

Study Selection Studies in any language quantifying the association of Internet-based instruction and educational outcomes for practicing and student physicians, nurses, pharmacists, dentists, and other health care professionals compared with a no-intervention or non-Internet control group or a preintervention assessment.

Conclusions Internet-based learning is associated with large positive effects compared with no intervention. In contrast, effects compared with non-Internet instructional methods are heterogeneous and generally small, suggesting effectiveness similar to traditional methods. Future research should directly compare different Internet-based interventions.

For a definition of figure elements, see the legend to Figure 2. All interventions occurred in a practice setting; hence, no contrast is reported for this characteristic. There are 32 interventions because the report by Curran et al39 contributed 14 separate interventions to this analysis. I2 for pooling all interventions is 79.1%.

Studies are classified according to relative between-intervention differences in key instructional methods; namely, did the comparison intervention have more (comparison >Internet), less (comparison <Internet), or the same (equal) amount of interactivity, practice exercises, discussion (face-to-face and Internet-based discussion combined), and repetition. Boxes represent the pooled effect size (Hedges g). P values reflect paired or 3-way comparisons among bracketed subgroups. Participant groups are not mutually exclusive; thus, no statistical comparison is made. All outcomes were subjectively determined; hence, no contrast is reported for this characteristic. Crossover studies assessed participant preference after exposure to Internet-based and non−Internet-based interventions. I2 for pooling all interventions is 92.2%.

For a definition of figure elements and study parameters, see the legend to Figure 5. All interventions were tutorials, and all outcomes were objectively determined except for 1 study in which the method of assessment could not be determined; hence, no contrasts are reported for these characteristics. I2 for pooling all interventions is 89.3%.

Return to: Internet-Based Learning in the Health Professions: A Meta-analysis

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